title: High-risk human papillomavirus (HPV) DNA sequences in metaplastic breast carcinomas of Mexican women.
abstract: BACKGROUND
  Metaplastic carcinoma, an uncommon subtype of breast cancer, is part of the spectrum of basal-like, triple receptor-negative breast carcinomas. The present study examined 20 surgical specimens of metaplastic breast carcinomas, for the presence of high-risk Human papillomavirus (HPV), which is suspected to be a potential carcinogenic agent for breast carcinoma.
  
  
  METHODS
  Mastectomy specimens from patients harboring metaplastic breast carcinoma, as defined by the World Health Organization (WHO), and who attended the Instituto Nacional de Cancerologia in Mexico City, were retrieved from the files of the Department of Pathology accumulated during a 16-year period (1995-2008). Demographic and clinical information was obtained from patients' medical records. DNA was extracted from formalin-fixed, paraffin-embedded tumors and HPV type-specific amplification was performed by means of Polymerase chain reaction (PCR). Quantitative Real-time (RT) PCR was conducted in HPV positive cases. Statistically, the association of continuous or categorical variables with HPV status was tested by the Student t, the Chi square, or Fisher's exact tests, as appropriate.
  
  
  RESULTS
  High-risk HPV DNA was detected in eight (40%) of 20 metaplastic breast carcinomas: seven (87.5%) HPV-16 and one (12.5%) HPV-18. Mean age of patients with HPV-positive cases was 49 years (range 24-72 years), the same as for HPV-negative cases (range, 30-73 years). There were not striking differences between HPV + and HPV- metaplastic carcinomas regarding clinical findings. Nearly all cases were negative for estrogen, progesterone and Human epidermal growth factor receptor 2 (HER2), but positive for Epidermal growth factor receptor (EGFR).
  
  
  CONCLUSIONS
  High-risk HPV has been strongly associated with conventional breast carcinomas, although the subtle mechanism of neoplastic transformation is poorly understood. In Mexican patients, the prevalence of HPV infection among metaplastic breast carcinomas is higher than in non-metaplastic ones, as so the HPV viral loads; notwithstanding, HPV viral loads show wide variation and remain even lower than cervical and other non-cervical carcinomas, making it difficult to assume that HPV could play a key role in breast carcinogenesis. Further studies are warranted to elucidate the meaning of the presence of high-risk HPVDNA in breast carcinomas.
authors.affiliation: Department of Pathology, Instituto Nacional de Cancerología México, México, Mexico. rhgoepfert@gmail.com.
authors.forename: Roberto
authors.initials: R
authors.lastname: Herrera-Goepfert
authors.forename: Teresa
authors.initials: T
authors.lastname: Vela-Chávez
authors.forename: Adela
authors.initials: A
authors.lastname: Carrillo-García
authors.forename: Marcela
authors.initials: M
authors.lastname: Lizano-Soberón
authors.forename: Alfredo
authors.initials: A
authors.lastname: Amador-Molina
authors.forename: Luis F
authors.initials: LF
authors.lastname: Oñate-Ocaña
authors.forename: Rita Sotelo-Regil
authors.initials: RS
authors.lastname: Hallmann
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000150:complications / Q000453:epidemiology / Q000473:pathology* / Q000821:virology*; D004279:DNA, Viral; D005260:Female; D018628:Gene Dosage; D052162:Human papillomavirus 16 / Q000235:genetics; D052161:Human papillomavirus 18 / Q000235:genetics; D006801:Humans; D008800:Mexico; D008875:Middle Aged; D060787:Neoplasm Grading; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D027383:Papillomaviridae / Q000235:genetics*; D030361:Papillomavirus Infections / Q000150:complications / Q000453:epidemiology / Q000821:virology*; D011960:Receptors, Estrogen / Q000378:metabolism; D012008:Recurrence; D047368:Tumor Burden
chemical_list: D004279:DNA, Viral; D011960:Receptors, Estrogen